And what it could mean for you

The Children’s Hospital of Philadelphia boldly declared earlier this month that it will ban from its pharmacy most dietary supplements because they are not regulated by the U.S. Food and Drug Administration. As such, says the hospital’s Therapeutic Standards Committee, the safety and effectiveness of these substances cannot be guaranteed.

The fact that dietary supplements like vitamins, minerals, herbs, and other natural alternatives to Western medicine are unregulated by the FDA is not breaking news. These items have never been under the FDA’s purview, and yet have been used or recommended by doctors for decades to help treat or prevent everything from the common cold to cancer.

The hospital, referred to as CHOP, based its decision not only on a lack of FDA regulation but also on a lack of clinical trials proving the benefits or risks associated with taking dietary supplements. And yet hospitals in the U.S. and beyond administer medications or therapies with known side effects to patients on a daily basis, because the benefits outweigh the potential risks.

Basically the first instruction any pregnant woman receives is to take a pre-natal supplement containing folic acid, a vitamin considered essential for fetal brain and spine development. Pediatric and adult patients who cannot tolerate solids or need to gain weight are frequently provided protein supplement shakes—would these too be disallowed? Are doctors who suggest patients take supplements causing harm? CHOP’s decision seems increasingly like a slippery slope toward calling into question the Hippocratic oath.

What’s more, untold numbers of people are vitamin deficient, whether as a result of an illness or disease, poor dietary habits, or other lifestyle choices. Not surprisingly, numerous health problems may result from such deficiencies. For instance, vitamin D deficiency has been linked to everything from cancer and cardiovascular disease to cognitive impairment and asthma. Not getting enough B vitamins can cause anemia, depression, and gastrointestinal problems. A lack of vitamin C can bring on nosebleeds, swollen and painful joints, and scurvy. The list of vitamin deficiencies and their associated illnesses is long and exhaustive.

Few health care professionals would argue that vitamin deficiencies lead to disease, and that for some patients it is virtually impossible to attain the recommended amounts of each vitamin through diet alone. Routine testing for vitamin deficiencies stands not only to help diagnose or treat health conditions, but may also save patients countless dollars on medical bills in the long run if a disease is prevented or halted through supplementation.

CHOP, the first hospital in the country to impose such strict standards on supplements, described its policy as a “clean sweep,” but noted it will continue using some key vitamins, minerals and amino acids verified by the U.S. Pharmacopeial Convention, a scientific nonprofit organization that sets standards for medicines, food ingredients, and dietary supplements manufactured, distributed and consumed worldwide.

Furthermore, just because the FDA or another regulating body puts their stamp of approval on something does not necessarily guarantee its quality. In 2004, the drug company Merck withdrew from the market its popular painkiller Vioxx after it was shown to increase the risk of heart attacks and strokes, and was linked to thousands of deaths.

By banning dietary supplements from its pharmacy, CHOP insists it has the best interests of its patients in mind, and I’m sure this is true. But any approach to healing or prevention should be integrative, malleable, and cautiously open-minded.

Billions of dollars are spent annually in this country and around the world on pharmaceutical research because of the possibility—the hope—that a drug will cure illness, relieve pain, or minimize a disease’s progression. It baffles me that the same serious study is not given to natural alternatives, which stand not only to help but may also do less harm.